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Jimmy and his family have multiple unmet needs, which can be meaningfully assessed and addressed through mental health services. Focusing on Jimmy, it would be crucial to first work with a team of psychologists that could offer tests to determine whether attention deficit/hyperactivity is indeed the source of Jimmy’s behavioral problems. While it is true that ADHD is associated with oppositional behavior, aggression, defiance, and conduct disorders, it is also true that medications used to treat children with these issues do tend to show marked improvement (Pringsheim, Hirsch & Gardner, 2015). The fact that Jimmy’s symptoms have worsened may seem to suggest that ADHD is not an accurate diagnosis and that the pharmacological intervention was either premature or unwarranted. Counseling services—especially family and group therapy—may be of particular use in this case.
Jimmy’s family situation, dynamics, and structure are complex but by no means unusual. Therefore, case workers can effectively build relationships with each family member in order to come up with strategic cognitive-behavioral interventions and social skills training that will help not just Jimmy but also his parents. Jimmy essentially has three parents: his biological mother, his step mother, and his biological father. Each of these...
Jimmy’s particular defiance towards his biological mother—such as his deliberate use of her first name and his taking some pleasure in displaying power over her—is a specific client need that can be addressed with cognitive behavioral techniques and family therapy.
Cognitive behavioral techniques should ideally focus most on Jimmy and Linda, his biological mother. Linda has her own needs as a client and can be treated individually as well as in family therapy with her son. Because Linda has exhibited substance abuse behaviors, is in an abusive relationship, and demonstrates other behavioral issues that have been causing her distress and disruptions in her life, it is critical to address these needs individually rather than just focusing on her parenting styles. Building a relationship between Linda and Jimmy will require ongoing and patient interventions and working with both clients simultaneously. Jimmy understandably disrespects and mistrusts his mother; his mother’s chronic low self esteem and inability to care for her own needs has hindered her ability to build the types of intimate relationships she needs to make improvements to…
References
Pringsheim, T., Hirsch, L., & Gardner, D. (2015). The Pharmacological Management of Oppositional Behaviour, Conduct Problems, and Aggression in Children and Adolescents with Attention-Deficit Hyperactivity Disorder, Oppositional Defiant Disorder, and Conduct Disorder: A Systematic Review and Meta-Analysis. Part 1: Psychostimulants, Alpha-2 Agonists, and Atomoxetine. The Canadian Journal of Psychiatry 60(2): 42-51.
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